Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients – compliance and satisfaction

BACKGROUND Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment. MATERIALS AND METHODS Twenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008 and September 2009. The first twelve patients were admitted for a maximum of 3 days during the initiation phase of brace treatment. The following twelve patients were initiated in an outpatient clinic set-up. In this later group, patients and parents were informed about the possibility to be admitted to the hospital, at the initiation phase but all patients chose to be treated as out patient's protocol. All patients were evaluated by means of conventional x-ray and patients reported outcome measurements. The mean follow up was 6 months for the outpatient group (3-8) and 12 months for the hospitalisation group (9-14). Scoliosis Quality of Life Index (SQLI) was used together with the Odense Scoliosis questionnaire, which was developed for this study. Compliance was measured using the patients' own statements and the Landauer compliance scoring system. FINDINGS/RESULTS The two groups' matches regarding the age, Risser grad, Cobb angle and primary correction. There were no statistically significant differences between the two groups regarding the SQLI and the Odense Scoliosis questionnaire. The compliance was higher in the ambulatory group. CONCLUSION Outpatient initiation of bracing in scoliosis seems to give the same correction but better compliance compared to initiation during hospitalization.